Date of Award

12-2021

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr. Rozina Karmaliani

Second Advisor

Dr. Muhammad Asim

Third Advisor

Dr. Murad Musa Khan

Department

Community Health Sciences

Abstract

Introduction: COVID-19 pandemic has affected every aspect of life from deteriorating health to the economic crisis which resulted in affecting the mental wellbeing of every individual. It is estimated that the burden of mental health issues will increase globally during and after the COVID-19 pandemic. Studies showed that mental health problems are likely to increase among the COVID-19 survivors, patients, and frontline healthcare providers. Various studies highlight that depression and an anxiety disorder among the COVID survivors has increased as compared to pre-covid time. There is a dearth of literature on the mental wellbeing of COVID-19 survivors in the Pakistani population. Hence, this study explores the experiences of survivors, family caregivers, and healthcare providers regarding the mental wellbeing and healthcare needs of the COVID-19 survivors in communities of Central Karachi, Pakistan.
Method: The exploratory case study design was used in the context of the population of Ayesha Manzil and Karimabad; areas in central Karachi. The study was performed in September and October 2021. The study recruited COVID survivors, aged between 20-40 years. Only those survivors were included who quarantined themselves at home through the snowball sampling technique. In addition, family caregivers of survivors and healthcare providers of central Karachi were also interviewed to triangulate the study and to find the availability of mental health services in the area. In-depth interviews and key informants’ interviews were used for collecting data and studying in detail the mental wellbeing of COVID survivors during the illness and quarantine. Survivors who were hospitalized and had any mental health problems were excluded from the study to reduce information bias. Moreover, the study was analyzed through the thematic analysis method.
Results: The key effects on COVID-19 survivor's mental wellbeing, coping strategies, and the response of healthcare providers were identified through six themes which include self-acceptance of life changes, personal growth, purpose in life, relationship with others, autonomy, and environmental mastery. Through these themes, we found that survivors suffered from denial, frustration, separation anxiety, fear, insomnia, and social IX stigma while suffering and being isolated. Like most of the survivors living in the small flats with a joint family system, they were also stressed about the quarantine facilities while not spreading the virus to their families. Moreover, survivors took religious and social support from family and friends, engaging themselves in their hobbies, and worked to cope with the negative consequences of the disease. It was also found that some survivors were having a positive attitude which includes the realization of nature’s blessings and finding happiness in small things. The findings of the study also indicate that there is nonavailability of public-funded mental health services. The presence of any such facility in the area may help COVID patients or survivors of central Karachi to mitigate the negative consequences of quarantine and isolation.
Conclusion: Study findings explicitly conclude that COVID survivors of central Karachi have suffered from negative mental wellbeing due to various factors which include low self-acceptance, the stress of being quarantined, fear of spreading the virus, separation anxiety, social stigmatization, and economic crisis. Furthermore, these survivors were being treated for their physical health and have a scarcity of mental health services in the area. Moreover, the study suggests initiating community-based mental health services and programs to cope with the negative mental wellbeing, and consequences of the disease. In addition, train LHW and CHW for barefoot counseling for COVID patients are recommended. This would help people to share their fears and their knowledge would improve as well. Furthermore, we also recommend the training of all general practitioners in mental health. This would help to diagnose survivors’ mental wellbeing issues at the initial stage and reduce the mental health burden in the country.

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